Organization
INTERVENTIONAL PAIN CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL NOLAN MD (MEMBER/OWNER)
(260) 579-1601
Entity
Organization
Contact information
Practice address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 387-0450
(260) 387-0440
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 387-0450
(260) 387-0440
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200931200
—
IN
Enumeration date
02/17/2009
Last updated
09/16/2014
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